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Emergency Services, LLC/ Copyright 2006 / Volume DISPATCH/SIZE-UP Firefighters were dispatch to a school for a bomb threat that proved to be false. Firefighters were then called back to a blaze at a commercial building. Initial size-up revealed fire in one interior location. Fireline Incident: Monmouth Commercial Bldg./Firefighter Fatality 06-5 Training Materials

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Emergency Services, LLC/ Copyright 2006 / Volume DISPATCH/SIZE-UP – FOLLOWING DAY Firefighters were dispatch to the same commercial building. Conditions were foggy and visibility poor, but size-up revealed multiple fires were set this time. Structure also appeared to have been weakened from the fire the day before. Fireline Incident: Monmouth Commercial Bldg./Firefighter Fatality 06-5 Training Materials

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Emergency Services, LLC/ Copyright 2006 / Volume STRATEGY/TACTICS – FOLLOWING DAY 1.75” and 2.5” handlines were used but because of structural weakness, limited interior work was done. An aerial extinguished the fires. Firewatch continued this time for most of the day. –Rehab, crew rotation, and food & water became issues. To deal with the LODD, CISD was mobilized. Fireline Incident: Monmouth Commercial Bldg./Firefighter Fatality 06-5 Training Materials

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Emergency Services, LLC/ Copyright 2006 / Volume EVENTS During the second fire, an Assistant Chief was checking a rear overhead door to see if it could be opened. In the process, weakened concrete around the door gave way, crushing him. He later died from his injuries. Mutual Aid was relied upon heavily to finish up the fire as Monmouth responders reacted to the LODD. After the bomb threat and coincidental second fire, an arson investigation was begun, resulting in convictions. Fireline Incident: Monmouth Commercial Bldg./Firefighter Fatality 06-5 Training Materials

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Emergency Services, LLC/ Copyright 2006 / Volume EVENTS Right after the second fire a large CISD defusing was held and a second one was held a few days later. Counselors were available in the interim. Fireline Incident: Monmouth Commercial Bldg./Firefighter Fatality 06-5 Training Materials

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Emergency Services, LLC/ Copyright 2006 / Volume LESSONS LEARNED The death of a responder can greatly affect a department but the thing to remember is that tragedy can strike even when a responder is just doing his job. Always be vigilant on the fireground. Fireline Incident: Monmouth Commercial Bldg./Firefighter Fatality 06-5 Training Materials

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Emergency Services, LLC/ Copyright 2006 / Volume DISPATCH Five responders, two on a rescue truck and three on a pumper, rolled up on a car crash. SIZE-UP Four people were in one vehicle –a woman passenger and driver in the front, and two in the back, one a young girl who was about 8. The two in the front were hysterical, but not injured. The young girl was severely injured. Fireline Incident: Galesburg Crash/Violent Patient 06-5 Training Materials

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Emergency Services, LLC/ Copyright 2006 / Volume EVENTS The passenger in the front was out of control. –As extricators tried to remove the passenger door, she was screaming obscenities and kicking at them. –They finally were able to bear-hug her and drag her out. Police officers handcuffed her to get her on a stretcher. Fireline Incident: Galesburg Crash/Violent Patient 06-5 Training Materials

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Emergency Services, LLC/ Copyright 2006 / Volume EVENTS The passenger was out of control. –She didn’t appear to have any injuries but had to be fully immobilized prior to transport. Responders provided psychological support and encouragement to the young girl. Fireline Incident: Galesburg Crash/Violent Patient 06-5 Training Materials

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Emergency Services, LLC/ Copyright 2006 / Volume STRATEGY/TACTICS A charged hoseline stood by for protection. The battery cable was cut. –Sometimes it should be cut, sometimes not. A battery out of service will hinder you from using some of the mechanisms in the car which might assist you in the extrication. Responders covered the patients in the back seat with aluminized blankets to protect them from glass. They used an ax to remove the front windshield. They then cut the roof posts and flapped the roof back in order to extricate the young girl. –If possible, start IV fluids and paramedic care during extrication. Fireline Incident: Galesburg Crash/Violent Patient 06-5 Training Materials

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Emergency Services, LLC/ Copyright 2006 / Volume LESSONS LEARNED It’s unusual to have combative patients in such a situation where firefighters are trying to lend assistance. –Usually alcohol or drugs are involved in such cases. –Sometimes patients perceive firefighters as the police and are afraid of criminal consequences so they fight back or act out. Fireline Incident: Galesburg Crash/Violent Patient 06-5 Training Materials

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Emergency Services, LLC/ Copyright 2006 / Volume LESSONS LEARNED On any kind of extended extrication or one with a traumatic injury, get a medic into the vehicle or near the patient for psychological support and to start IV fluids which might be necessary. Removing the roof might be slightly more dangerous for the patient but it can be a quicker solution. The noise of an extrication can be frightening to a child so a quicker removal is advisable. This would also reduce the amount of psychological support to the eight year-old who would probably be very scared from the noise and activity and her injuries. Fireline Incident: Galesburg Crash/Violent Patient 06-5 Training Materials

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Emergency Services, LLC/ Copyright 2006 / Volume LESSONS LEARNED Reviewing and critiquing: you often know things can be improved upon and having a critique soon after the incident will help you isolate on the few things you could have done better. –At the time, you may have done something without thinking which, when analyzed later, seems kind of pointless or unnecessary. –Critiquing is designed to get benefits out of the incident by seeking improved performance. Fireline Incident: Galesburg Crash/Violent Patient 06-5 Training Materials

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Emergency Services, LLC/ Copyright 2006 / Volume LESSONS LEARNED Incident commanders shouldn’t get involved in the actual rescue activity – though it happens sometimes – because the officer then loses that wider perspective on the mission and safety considerations. That should be the main concern. Fireline Incident: Galesburg Crash/Violent Patient 06-5 Training Materials

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Emergency Services, LLC/ Copyright 2006 / Volume Department Discussion The departments involved in this month’s training pose some discussion questions that you can use as discussion-starters in your own department’s training sessions. How will your department handle these scenarios? 06-5 Training Materials

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Emergency Services, LLC/ Copyright 2006 / Volume Monmouth Commercial Bldg./Firefighter Fatality / Monmouth, IL Asst. Chief Wayne Grant, Monmouth (IL) Fire Department Always pay attention to calls that don’t “smell right.” Be aware of crank calls that might be a diversion. If you get two calls back-to-back to the same location, begin to think “arson.” A line-of-duty death is the worst thing that can happen to a department. Line up Critical Incident Stress Management in advance – you never know Training Materials Fireline Incident Discussion

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Emergency Services, LLC/ Copyright 2006 / Volume Galesburg Crash/Violent Patient / Galesburg, IL Bat. Chief Tom Simkins, Galesburg (IL) Fire Department Have you ever encountered a patient who violently resisted care? Do you have a procedure or SOG for handling such an event? Do you or your EMS crews have special procedures for handling injured children? Does the presence of an injured child change the way you handle the incident? Don’t forget the necessity of getting consent, if possible, from a parent or guardian in order to treat the child Training Materials Fireline Incident Discussion

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Emergency Services, LLC/ Copyright 2006 / Volume PRE-BRIEFING Rapid Intervention Team (RIT) Scenario –Report of firefighter down and basic location –Looking for dummies or bodies Firefighter down on 5th floor. Usually the crew would take an infrared camera with them. In this scenario, no camera will be used and crew will be working with blacked-out faceplates Training Materials Hands-On: Hotel Response, Pt. II

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Emergency Services, LLC/ Copyright 2006 / Volume THE EVOLUTION Crew members rig a tag line using webbing off the search rope for an area search into the suspected room. They find downed firefighter. –Crew radios in status and situation. –Firefighter is trapped under collapsed roof debris and says he’s just about out of air. –They remove debris and evaluate his air supply situation. –He says he tried to open window but couldn’t get his head out Training Materials Hands-On: Hotel Response, Pt. II

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Emergency Services, LLC/ Copyright 2006 / Volume THE EVOLUTION Buddy-breathing won’t work because devices don’t match. –There’s not time to wait for a fresh air bottle. It’s time to just get him out. Firefighter says he could walk out if they could help him up. They do that and began to exit following the rescue rope Training Materials Hands-On: Hotel Response, Pt. II

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Emergency Services, LLC/ Copyright 2006 / Volume POST-BRIEFING Evaluation: –As soon as you hear the PASS device, start yelling out to see if the patient will respond and give you any information that might be helpful Training Materials Hands-On: Hotel Response, Pt. II

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Emergency Services, LLC/ Copyright 2006 / Volume POST-BRIEFING Evaluation –As soon as you hear the PASS device, start yelling out to see if patient will respond and give you any information that might be helpful. Does downed firefighter answer? Is he unconscious? Can he help pin down his location? The PASS device might have been a portable one which fell off someone else, so by yelling out, you might learn if it’s attached to a live person or not. –Crew members were in front and behind firefighter directing him, keeping him in contact with the rescue rope, and warning of any obstructions Training Materials Hands-On: Hotel Response, Pt. II

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Emergency Services, LLC/ Copyright 2006 / Volume POST-BRIEFING Evaluation –Also remember to relay to Command how many are coming out. If two went in, three should be coming out. If one rescuer is staying behind for some reason, communicate that information Training Materials Hands-On: Hotel Response, Pt. II

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Emergency Services, LLC/ Copyright 2006 / Volume POST-BRIEFING Suggestions –Stage extra rope in the stairwell that could be added to the rescue line at that location with a quick request by radio. Remember from Part I, your biggest obstacle is not having enough rope. –Bring an extra R.I.T. Pack or not? This is often debated and comes down to department SOG and individual situation. If you bring the extra air bottle with you, some feel it slows down your initial search -- and you may come to find you don’t need it; for example, the downed firefighter may only be entrapped by obstacles. If you DON’T bring the air bottle, others feel you can find the victim faster and you’ll know his exact location, so bringing up an extra R.I.T. pack afterward shouldn’t take much time Training Materials Hands-On: Hotel Response, Pt. II

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Emergency Services, LLC/ Copyright 2006 / Volume POST-BRIEFING Suggestions –Buddy-Breathing didn’t work in this case because the rescuer’s device didn’t match the victim’s. They do make R.I.T. packs with multiple interfaces, so if you called for the R.I.T. pack after you found the victim, you could even specify which brand of device the victim has so you would know you’d have the right one when the new R.I.T. pack arrived Training Materials Hands-On: Hotel Response, Pt. II

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Emergency Services, LLC/ Copyright 2006 / Volume POST-BRIEFING Suggestions –Take a page from wide-area search & rescue technique and use webbing as extenders off the main rescue rope to go into the rooms -- then slide up the main line and search the next room. The webbing always leads you back to the main line safely. Also, you might want to develop a system where one rescue team searches one side of the corridor and the next team searches the other side. The third team would then search the same side as Team #1 but beyond where they left off. You can do it anyway you want, but come up with a system that works and train on it. Make it a part of your SOG, if necessary Training Materials Hands-On: Hotel Response, Pt. II

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Emergency Services, LLC/ Copyright 2006 / Volume POST-BRIEFING Suggestions –Here’s a typical example of a multiple search pattern. In this case, three rescuers hook webbing onto the main search rope and span out, searching three rooms at a time on the left side. They then move up as a unit and search the next three rooms. The team that follows them searches the right side in the same way Training Materials Hands-On: Hotel Response, Pt. II Rescuer #1 Rescuer #2 Rescuer #3 Rescuer #1 Rescuer #2 Rescuer #3 Rescuer #1 Rescuer #2 Rescuer #3 Rescuer #1 Rescuer #2 Rescuer #3 Main Line Rescue Rope Hotel Corridor 1st Rescue Team 1st Rescue Team 2nd Rescue Team 2nd Rescue Team

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Emergency Services, LLC/ Copyright 2006 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 1. True or False: R.I.T crews might have to be larger to search a hotel. 2. True or False: Staging additional search rope in the stairwells is a bad idea because it becomes a safety obstacle to firefighters using the stairwell. 3. True or False: Buddy-Breathing or bottle changeovers are a waste of time since you can’t be sure you’ll have the right devices that match up. Hotel Response, Pt. II: Quiz

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Emergency Services, LLC/ Copyright 2006 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 5. Which search method works best? a. Searching different sides of the corridor with different teams b. Searching the same sides of the corridor with different teams c. Using webbing in an area search pattern method d. Locating the victim and then calling for an R.I.T. pack. e. Bringing the R.I.T. Pack on the initial search f. Possibly any of the above depending upon your protocol g. None of the above (Answers on Slide 68) Hotel Response, Pt. II: Quiz

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Emergency Services, LLC/ Copyright 2006 / Volume TRAINING OBJECTIVES Objectives of 14 ft. Roof Ladder Training –Single-person raise –Position it with proper placement –Achieving the proper climbing angle –Ascending and descending These are skills that can be used at any fire on any day. Ladder skills will: –allow rescues with ladders –allow access to and egress from structures –assist in proficiency in interior firefighting and R.I.T. work Training Materials Hands-On: Ladder Skills Training

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Emergency Services, LLC/ Copyright 2006 / Volume LADDER SAFETY Stable Ground –Check the ground under the ladder feet to make sure it's stable enough to support the weight of the ladder and people on it. Ladder Angles –To be safe, a rigid ladder should be leaned at an angle of about fifteen degrees from the vertical. In other words, the distance from the foot of the ladder to the wall should be about one quarter of the height to the top of the ladder. At steeper angles, the ladder is at risk of toppling backwards when the climber leans away from it. At shallower angles, the ladder may lose its grip on the ground Training Materials Hands-On: Ladder Skills Training

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Emergency Services, LLC/ Copyright 2006 / Volume LADDER SAFETY Ladder Angles –How can you tell if a ladder is too steep? If the climber has to turn his/her knees outside the beams of the ladder, it's too steep and he'll be too close to it. If a rescuer were carrying an occupant or the occupant were dropped on the rescuer, that out-turned knee might get blown out Training Materials Hands-On: Ladder Skills Training

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Emergency Services, LLC/ Copyright 2006 / Volume AVOIDING INJURIES Ladder Team –Before a ladder is climbed, a ladder crew member should help stabilize the ladder foot from slipping or creeping by "chocking" his own foot against the beam on the ground. –Another crew member should position himself under the ladder, facing it, and pulling the ladder toward the structure to keep it from bouncing as a climber ascends Training Materials Hands-On: Ladder Skills Training

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Emergency Services, LLC/ Copyright 2006 / Volume EXTENSION LADDER – TWO-PERSON CARRY Pickup & Carry –Hoist the ladder over the closest shoulder between rungs –Extend the hand of the opposite arm across the chest and place the palm over the end of the top beam of the ladder. Beam Raise –Lift: With the ladder resting perpendicular on the ground with the beam up and perpendicular to the structure, raise one end of the ladder by the beam while the other end is held stationary by your partner Training Materials Hands-On: Ladder Skills Training

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Emergency Services, LLC/ Copyright 2006 / Volume EXTENSION LADDER – TWO-PERSON CARRY Beam Raise –Lift: Lifting the ladder up, walk under the ladder toward the stationary end, pushing it up with your hands as you go, until the ladder is standing on end. Ladder stabilizers are available that increase the ladder's grip on the ground Training Materials Hands-On: Ladder Skills Training

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Emergency Services, LLC/ Copyright 2006 / Volume EXTENSION LADDER – TWO-PERSON CARRY Rotate –The ladder is rotated from perpendicular to the structure to parallel. At this point, more than two people are helpful in controlling the ladder, especially if it's going to be extended to a great height. Extend –To extend the ladder, carefully haul on the halyard until the ladder has achieved its desired height. Then make sure the ladder rung locks are secured so the extension won’t slip Training Materials Hands-On: Ladder Skills Training

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Emergency Services, LLC/ Copyright 2006 / Volume EXTENSION LADDER – TWO-PERSON CARRY Placement –"Walk" the ladder on its feet either toward or away from the structure to attain the proper ascending angle. –This "walking" of the ladder may have to be done a couple of times, along with changing the extension height, until it can be leaned against the structure at the desired height. –The ladder is then leaned into place against the structure. –A ladder standoff, or stay, is a device fitted to the top of a ladder to hold it away from the wall. This enables the ladder to clear overhanging obstacles such as the eaves of a roof, and increases the safe working height for a given length of ladder Training Materials Hands-On: Ladder Skills Training

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Emergency Services, LLC/ Copyright 2006 / Volume EXTENSION LADDER – TWO-PERSON CARRY Ascend –A climber should always be able to climb the ladder with his knees straight in front of him. –As he climbs, he places his hands on the rungs - not on the rails -- and pulls himself up. –Climbing a ladder wearing boots is a little more awkward than practicing with station wear, so you should occasionally practice with boots Training Materials Hands-On: Ladder Skills Training

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Emergency Services, LLC/ Copyright 2006 / Volume EXTENSION LADDER – TWO-PERSON CARRY Leg Lock –Although it's not good to work on a ladder for long periods of time, if a climber must stop for a while, he should lock his leg to the ladder. Insert the right leg through and over a rung and place the foot on the rung just below. The climber then steps down a rung with his left leg, forcing the rung above his right foot into the bend of his knee and allowing him to pull his right foot toward him off the top of that rung, curling the top of his ankle against the rung - or outside the beam at that level. Either way is acceptable; do what feels comfortable for you. There are other locking methods, many of which were developed to accommodate different legs lengths Training Materials Hands-On: Ladder Skills Training

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Emergency Services, LLC/ Copyright 2006 / Volume EXTENSION LADDER – TWO-PERSON CARRY Descend –The same as ascending but in reverse. Lowering the ladder and repacking –Pull the ladder away from the structure until it's vertical. Lower the extension using the halyard in the reverse method of raising it. Secure the halyard. –Lower the ladder in the reverse way it was lifted up. First, rotate the ladder from the parallel to a position perpendicular to the structure. –Then by walking backwards, "walk" the ladder down to the ground by the rungs, doing a reverse rung-raise (a rung- lower?). –Lift and carry the ladder as before and repack it on the truck Training Materials Hands-On: Ladder Skills Training

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Emergency Services, LLC/ Copyright 2006 / Volume SINGLE SECTION LADDER – SINGLE-PERSON CARRY Picking ladder up and carrying –Kneel down and pull the ladder up from lying flat to laying on its beam. Then stand up, holding the ladder by its vertical rungs at the mid-point. Carry it in this position. –When you get to the structure, do the reverse and set the ladder down on the ground flat, perpendicular to the structure, with the ladder feet flush against the structure. This keeps the ladder from sliding during the rung-raise. Rung-Raise –Walk to the end of the ladder away from the structure and pick it up. Then lift it up and continue to "walk" it upward, performing a rung-raise as you walk toward the structure. The ladder will now be flush against the structure in a vertical position Training Materials Hands-On: Ladder Skills Training

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Emergency Services, LLC/ Copyright 2006 / Volume SINGLE SECTION LADDER – SINGLE-PERSON CARRY Placement –Grasp the beams of the ladders with your hands about waist- high. –Lift and carry the feet of the ladder outward away from the building until the correct climbing/ascending angle is achieved. Ascending/Descending –The ladder is ascended and descended as before, with a crew member stabilizing it from underneath as before Training Materials Hands-On: Ladder Skills Training

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Emergency Services, LLC/ Copyright 2006 / Volume SINGLE SECTION LADDER – SINGLE-PERSON CARRY Lowering the ladder –With a single person, this can be done doing the rung-lower as before and laying the ladder on the ground. –With two people, the crew member who was stabilizing the ladder from underneath helps pull the ladder from the structure to a vertical person, in the same way as the extension ladder. –From this position, the stabilizer chocks the feet of the ladder with his feet and, bending at the waist, allows the ladder to be lowered to the other crew member who does the rung-lower while walking backward away from the structure, until the ladder is laid flat on the ground. –Lift and carry the ladder as before and repack it on the truck Training Materials Hands-On: Ladder Skills Training

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Emergency Services, LLC/ Copyright 2006 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 1. True or False: “Walking” a ladder is perfectly permissible on a fire scene. 2. True or False: Checking the ground underneath a ladder for stability is must for safety. 3. True or False: A leg lock is great for wrestling but should never be done on a ladder. Ladder Skills Training: Quiz

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Emergency Services, LLC/ Copyright 2006 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 4. Which instruction listed below for raising a ladder is incorrect? a. To extend the ladder, carefully haul on the halyard until the ladder has achieved its desired height. b. Ladders can be moved with a climber on the ladder by “hopping” the ladder along the building. c. Lifting the ladder up, walk under the ladder toward the stationary end, pushing it up with your hands as you go, until the ladder is standing on end. d. The climber then steps down a rung with his left leg, forcing the rung above his right foot into the bend of his knee. e. None of the above. Ladder Skills Training: Quiz

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Emergency Services, LLC/ Copyright 2006 / Volume Date___________ Firefighter/PM____________________ Chief/T.O.___________________ Education Credits _____ Select the best answer: 5. Which of the following safety issues is incorrect? a. A climber should not climb a ladder with his knees outside the beams. b. To be safe, a rigid ladder should be leaned at an angle of about thirty degrees to the vertical. c. At least two additional crew members should help stabilize a ladder usage and keep it safe. d. Maintenance of ladders is important to their safe usage. e. None of the above. (Answers on Slide 68) Ladder Skills Training: Quiz

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Emergency Services, LLC/ Copyright 2006 / Volume Fire Medics: Medical/Legal Issues, Pt. IV 06-5 Training Materials CIVIL VS. CRIMINAL LAW Civil: Money Damage & Civil actions –Civil Actions Assault & Battery - In Missouri and other states, it's just called Assault now. –i. Assault is placing someone in apprehension of a harmful or offensive touch. Check the laws and designations in your state. –ii. Just threatening someone with touching them without actually doing so, but making the person fearful that you might, is assault. Or a better example, trying to persuade someone who hates needles by coaxing them while bringing the needle close to the skin. –iii. Assault doesn't have to be harmful; touching someone inappropriately can be assault. – iv. Battery is actually hitting the person or making contact with them.

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Emergency Services, LLC/ Copyright 2006 / Volume Fire Medics: Medical/Legal Issues, Pt. IV 06-5 Training Materials NEGLIGENCE - SIMPLE & GROSS Simple –All four must be present Duty -- there is a duty of care owed to the patient. Breach of Duty -- there was a breach or interruption of that care. Causation -- there was a reasonably close casual connection that the breach caused injury. Damage -- the injury caused actual damage or loss.

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Emergency Services, LLC/ Copyright 2006 / Volume Fire Medics: Medical/Legal Issues, Pt. IV 06-5 Training Materials NEGLIGENCE - SIMPLE & GROSS Simple –You have to have them all present to be negligent. However, your ability or duty to act may be limited by the lack of tools or equipment that are available, as in the case of the Good Samaritan who happens to be a paramedic who stops to help. Without the tools, there is no "breach," hence, no negligence. –Contributory Negligence is involved when something you did or didn’t do may have contributed to or led to a casualty or death. Indicates partial responsibility on your part to some degree.

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Emergency Services, LLC/ Copyright 2006 / Volume Training Materials Evolutions 2000: Continuing Education Kramer vs. Kramer: Firefighter Fatalities Complete written responses to the following three essay questions: 1. Should fatalities among firefighters be considered inevitable in light of the dangerous nature of the profession? Why or why not? 2. What steps can be taken nationally and regionally to reduce firefighter fatalities toward the ultimate goal of zero? 3. Describe a firefighter fatality with which you are familiar. What lessons were learned or what lessons should have been learned to help prevent a similar future fatality? If you’re enrolled in the Open Learning Fire Service Program at the University of Cincinnati, here’s your opportunity this month to earn one college credit hour for watching Working Fire Training.

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Emergency Services, LLC/ Copyright 2006 / Volume ENROLLMENT INFORMATION: For more information on enrolling in the Open Learning program to gain college credit, call Working Fire Training at for a brochure or, to register directly, call the University of Cincinnati at Associates and Bachelors programs are available. Call to have your transcripts evaluated. Send your responses to: Professor Bill Kramer University of Cincinnati College of Applied Science 2220 Victory Parkway, ML #103 Cincinnati, Ohio Training Materials Evolutions 2000: Continuing Education